Assessing

the Nose
and
Sinuses
THE NOSE
External Parts:
• Bridge
– superior part of the nose
• Tip
– anterior part of the nose
• Nares
– two oval openings
Nasal Cavity
– located between the roof of the mouth and the
cranium and then extends from the anterior nares to
the posterior nares

• Nasal Septum
– separates the nasal cavity into
two halves.
• Turbinates / Conchae
– passageways that helps warm
and moisten the air flowing through
the nose.
• Vibrissae / Nasal Hair
– filters large particles from the air
being inhaled.
• Meatus
– underlies each turbinates and
receives drainage from the
paranasal sinuses and
nasolacrimal duct
 The Paranasal Sinuses
are air-filled cavities that decrease the weight of the skull
and acts as a resonance chambers during speech

 Frontal
 Maxillary
 Ethmoidal
 Sphenoidal

Take note:
 Only the Ethmoid and Maxillary sinuses are present at birth.
 Frontal develop between 7 and 8 years.
 Sphenoid develop after puberty.
 Only the Frontal and Maxillary sinuses are accessible to physical examination
 Sinuses are often a primary site of infection because they can easily become blocked.
COLLECTING
SUBJECTIVE DATA

Preventive teaching:
COLLECTING
SUBJECTIVE DATA

Discomfort and loss of function:

COLLECTING
SUBJECTIVE DATA

Evaluate Health Practices:

 COLLECTING
SUBJECTIVE DATA

DO YOU HAVE PAIN IN YOUR SINUSES?

Acute Sinusitis (temporary) Chronic Sinusitis (12 weeks or longer)
 COLLECTING
SUBJECTIVE DATA

DO YOU EXPERIENCE NOSEBLEEDS? (DESCRIBE AMOUNT OF

BLEEDING, COLOR, AND HOW OFTEN IT OCCURS)
COLLECTING
SUBJECTIVE DATA

DO YOU EXPERIENCE FREQUENT CLEAR OR MUCOUS

DRAINAGE FROM YOUR NOSE?
Rhinorrhea
COLLECTING
SUBJECTIVE DATA
DECREASE ABILITY OF SMELL
 Acute and Chronic upper respiratory infections
 Smoking, cocaine use, or a neurologic lesion or tumor in
the frontal lobe of brain/olfactory bulb or tract
CHANGES IN SMELL PERCEPTION
 Zinc deficiency
OLDER ADULT CONSIDERATIONS
 Menopause The ability to smell and taste
decreases with age. Medications
can also decrease sense of smell
and taste in older people.
ASSESSING THE
NOSE AND
SINUSES
 PREPARE THE PATIENT
1. Introduce yourself to the client and verify the client’s identity using the
agency protocol. Explain to the client the procedures to be done.
2. Perform hand hygiene.
3. Provide client’s privacy.
4. Ask the client is he/she has any allergies, difficulty in breathing through the
nose, sinus infections, injuries to on the nose or face, nosebleeds, changes in
sense of smell, and has taken any medications,
5. Position the client comfortably.
 EQUIPMENTS NEEDED FOR
ASSESSING THE NOSE AND
SINUSES
• Nasal Speculum • Penlight
EQUIPMENTS NEEDED FOR
ASSESSING THE NOSE AND
SINUSES
Otoscope
 ASSESMENT PROCEDURE
External Nose (Inspection)

Inspect and palpate the external nose. Take

note of the nasal color, shape, consistency,
and tenderness.

Check patency of air flow through the nostrils

by occluding one nostril at a time and asking
client to sniff.
Internal Nose (Inspection)
Inspect the internal nose. To inspect the internal nose, use an otoscope
with a short wide-tip attachment or you can also use a nasal speculum
and penlight.

CLINICAL TIP:
Position the
otoscope’s handle to
the side to improve
your view of the
structures. If an
otoscope is
unavailable, use a
penlight and hold
the tip of the nose
slightly up. A nasal
speculum with a
penlight also
facilitates good
visualization.
Sinuses (Palpation, Percussion, and
Transillumination)

• Palpate the frontal sinuses

• Palpate the maxillary sinuses

 • Percuss the sinuses.
• Transilluminate the sinuses.

CLINICAL TIP:
Upper dentures should be removed so that the light is not
blocked.
Common Abnormalities of the Nose